I Had a Routine Appointment With My OB/GYN — And Then They Called the Cops

The last thing new moms struggling with postpartum depression need is to feel like they can't confide in their own health care providers.

By
Sarah Yahr Tucker

Mar 3, 2018

McKay Photography

At 2 p.m. on Thursday, January 18, Jessica Porten walked into her OB/GYN's office in Sacramento, California. She was carrying her 4-month-old daughter, Kira, her second child. This would be her first appointment after giving birth, and Jessica had a list of health concerns that she wanted to discuss with her doctor: She needed a pelvic exam. She needed a birth control consult. And she needed to talk about postpartum depression, which she suspected might be causing some emotional symptoms. As Jessica settled herself in the waiting room, she had no idea that 18 hours later, she would be writing on Facebook about one of the most traumatic and terrifying experiences of her life. She had no idea that TV news producers would soon know her name, or that 11,000 strangers would comment on her post, expressing sympathy and shock, and relating their own stories of suffering.

Jessica and her daughter, Kira.

Courtesy of Jessica Porten

2 P.M. - 4 P.M.: Greeting the Police

More than an hour of waiting later, Jessica was brought into an exam room and a nurse practitioner followed. It was woman she knew from a previous visit during her pregnancy, a nurse whom Jessica recalled as having a poor bedside manner. Jessica began to describe her concerns: "I have postpartum depression that is manifesting in fits of anger, and I want to discuss my medication options," she says. "I tell them [that] although I would never hurt myself or my baby, I'm having violent thoughts." She said she needed medication or therapy, or both.

"I thought it was going to be a routine appointment," Jessica tells me later, during a phone interview. "I was talking kind of quickly, and [the nurse] seemed a little bit overwhelmed … I saw it in her face, the moment that she stopped listening to me and started making a plan. As soon as I said I had violent thoughts, a red flag went off in her head. I was like, 'Why is this woman not listening to me? Why is she rushing through everything? What is going on right now?'" After doing a pelvic exam, the nurse told Jessica that she was going to call the police.

Estimates about the prevalence of postpartum depression (PPD) and other maternal mental health disorders in the U.S. are imprecise and can vary by state. The nonprofit California Health Care Foundation reports that 1 in 5 California women suffers from depression or anxiety during pregnancy or the postpartum period. The rates for African American and Latina mothers are even higher, and these numbers only reflect women who report their symptoms. Research also suggests that only 15% of women diagnosed with these disorders ever receive professional treatment.

An average family night, Jessica snaps a selfie with her husband, Scott, and two daughters, Luna and Kira.

Courtesy of Jessica Porten

Shocked and confused by the nurse's announcement, Jessica tried to reason with her. Aware of "trigger words" that might indicate suicide risk or dangerous disorders like postpartum psychosis, Jessica was adamant that she would never harm herself or her children. But the nurse insisted that she had no choice. Jessica remembers the nurse saying, "Okay, even though you're telling me you're not going to, I still have to call the cops." Jessica would hear this protocol explanation over and over during the next nine hours. "It was like once the ball got rolling, no one could stop it," Jessica says, "Everyone was just covering their own liability."

I was afraid that if I had a reaction they would commit me.

The chilling events that followed had almost comic inconsistencies. The police officers, realizing that they couldn't install Kira's car seat in their cruiser, allowed the clearly competent Jessica to drive her own car to the emergency room. The hospital staff scrupulously removed Jessica's clothes and flip-flops, in case she was hiding weapons or drugs, but allowed her to keep Kira's diaper bag. The nurses demanded that Jessica's husband Scott find childcare for their older daughter and drive to the hospital because they couldn't be responsible for Kira, but then suggested that he run out to McDonald's to pick up dinner. (Several voicemails left for the operations manager at Jessica's OB/GYN office requesting comment were not returned. However, the Sacramento Police Department confirmed in an email that they responded to a call by the office on January 18 and provided assistance.)

4:30 P.M. - 12 A.M.: Proving My Stability

While Jessica was triaged in the ER, had blood and urine taken, and waited for hours in a hospital room watched by a security guard, Jessica forced herself to stay calm. "I was afraid that if I had a reaction they would commit me," she says. "My goal was to not be separated from my baby."

As day turned to night, Jessica was evaluated by a social worker, who saw no evidence that she was unstable, unfit to parent, suicidal, or a danger her children, and determined that a psychiatric hold was unnecessary. Around 10:45 p.m., she signed Jessica's discharge form and handed her a stack of Xeroxed papers with information on maternal mental health resources. This is when Jessica's calm began to crack. "I stayed there and I argued," she says. "I put up a stink. I was like, 'This is it? The ER doctor doesn't prescribe anything? This is the end of your job for real?' And they said, 'Yeah, these are really good resources. Use these resources.'"

Jessica's husband, Scott, and daughter, Kira, in the hospital room where Jessica was being held for psychiatric evaluation.

Courtesy of Jessica Porten

In disbelief, Jessica pressed for answers. "What if I didn't have a support system at home?" she asked. "You're expecting me to call these people? Why are you expecting me to advocate for myself if I have postpartum depression?" Jessica recalls the social worker looking her in the eyes and telling her, "I know that it isn't right, but I need you to advocate for yourself on this one." At that point, Jessica says, she was done. "What if I was a single mother? They could have taken my kids away. I was outraged."

Jessica, Scott, and Kira left the hospital at 12 a.m. the following day, on January 19. Jessica believes that at no time during this 10-hour ordeal was she ever seen by a doctor, a claim the hospital disputes. Gary Zavoral, a spokesman for Sutter Medical Center, doubts Jessica's claim that she was never seen by a doctor while she was there. Zavoral writes in an email that "every patient on a behavioral health hold is seen by a care provider (M.D., P.A. or N.P.) upon arrival at the hospital." Zavoral also mentions Sutter Medical Center's "A Mother's Heart" support group for women with postpartum depression and anxiety. Although, Sutter Women's Ambulatory Services Coordinator, Jacqueline Masullo, who runs the group says attendance is low, due to the fact that PPD itself can be "a barrier to accessing care."

The Next Day: Going Viral

For Jessica, the fact that she might have PPD wasn't that alarming. "I could name it, I knew I had it," she says. "So, it wasn't scary for me." But the response from the health care system left Jessica feeling like her "spirit was broken" and she had been "treated like a criminal." When she wrote about her experience on Facebook later that morning, thousands of people immediately began commenting and re-posting her story. "Bless you for your courage," one commenter wrote, "Yes, the system is HUGELY broken." Others raged, "Your OB failed you and your family!" And many more confessed, "This is EXACTLY why I didn't talk to my doctor."

In fact, it was not only Jessica's obstetrician who may have failed. Her story is a catalog of health care failures that may actually have begun much earlier. "It sounds like there were multiple breakdowns in terms of her care process," says Julie Hohmeister, a Women's Health Nurse Practitioner in Littleton, New Hampshire. "Having been in health care as a nurse practitioner for almost 30 years, I have never considered calling the police for a woman who was either depressed or even psychotic."

Fighting for Change

Jessica's story may actually begin on the day she gave birth. Newborn Kira was rushed into the Neonatal Intensive Care Unit (NICU) due to meconium aspiration where she would stay for two weeks. Jessica describes this experience as devastating. "That was the most depressed I have ever been in my entire life," Jessica says. "She had tubes hanging out of her nose and IVs and things. I couldn't hold her or pick her up. We couldn't do skin-to-skin. I couldn't nurse her."

The incidence of postpartum depression for mothers of infants admitted to the NICU is thought to be much higher than the general rate, and may be as high as 70%. Both mothers and fathers of NICU infants also have an increased risk of post-traumatic stress disorder (PTSD). Sacramento's Sutter Medical Center where Jessica was admitted on January 18 was the same hospital where she had given birth four months earlier, the same one where she had waited, anxiously watching her baby who was covered in medical equipment. During those two weeks, Jessica says a social worker was assigned to help her family through the process. But once Kira went home, it was a nurse who followed up to monitor Kira and not Jessica's condition. NICU Guidelines from the National Institute of Health and the National Association of Perinatal Social Workers recommend that a social worker stay in touch with parents after babies are discharged, but it is unclear how many hospitals are doing that.

While proper medical protocol is up for debate, there's one thing Jessica wishes the nurse practitioner had done back in that OB/GYN office on January 18: Ask questions. "It all started when I would rock [Kira] in a glider that we had," Jessica says when asked to describe what was causing her to feel like she may have PPD. "And then the glider started squeaking. I was so, so angry at that stupid chair. I wanted to take an axe to it. I wanted to make it kindling."

Jessica at the 2018 Women's March in Sacramento, California.

Courtesy of Jessica Porten

In spite of her traumatic experience, Jessica says she intends to stay with her current obstetrician, hoping that the publicity around her Facebook post will force the office to change its approach to maternal mental health. Although Jessica declined to say what type of treatment she has chosen to address her PPD, she maintains that her family is currently "happy, healthy, and safe." She has also partnered with a nonprofit organization, 2020Mom, which provides maternal mental health resources and lobbies for state and federal legislation. Jessica does not believe that what happened to her was simply an unfortunate mistake. And based on the thousands of Facebook comments with similarly painful stories, it was not an isolated incident.

Most of all, Jessica hopes her story won't prevent other women from seeking treatment for PPD and other maternal mental health disorders. To them her message is clear: "Please don't keep it to yourself. Please do not let what happened to me dissuade you from telling someone you trust. There are a lot of really great doctors out there and great doulas and midwives. If you don't feel like you have anyone to tell, call Postpartum Support International. I think that in your heart, if you're not feeling safe, you'll know who you can tell."

If you or someone you know is dealing with postpartum depression, contact Postpartum Support International at 1-800-944-4773.

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